Insurance Dependent Dentists

The parents of a 15 year old boy asked their insurance company if they would allow me to restore his broken front tooth after the root canal was completed. I am not in their network and therefore the insurance company must provide an exception to go out of network. I received a copy of the denial and the insurance company stated that they have many dentists in their network who are 'qualified' to restore  the front tooth of the boy.

Oh really????

Let's explore what the insurance company is saying. They are saying that their dentists are capable of fixing the tooth...the color might not be right, the shape may not look like the adjacent tooth, and it may not even be mostly natural tooth structure since many dentists would justify a crown as the tooth had a root canal and there was a (moderately) small chip in the tooth.

When an insurance company states that a dentist is 'qualified' they do so not by actually looking at examples of the work of each dentist. They find dentists who  have a license, haven't been sued too many times and are willing to work for up to 50% less than their usual fee.

If I was going to qualify a dentist to restore the front tooth of MY SON, I would want to look at the following:

1. Many photographs of broken front teeth that the dentist restored
2. How many hours of continuing education the dentist has in restoring front teeth
3. Whether the dentist holds any certifications in fixing front teeth such as a Certificate of Proficiency in  Esthetic Dentistry from a Dental School
4. How many different kinds and shades of resins the dentist will use to restore front teeth since most use 3 or 4 instead of having 30-40 resins available.

Oh yes, dentists should be 'qualified' to perform certain areas of dentistry but that qualification  should not be based on reducing his/her fee by up to 50%.

Dentists who charge 50% less KNOW what their work is worth.